July 2019
Volume 60, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2019
Clinical outcomes after switch from aflibercept to ranibizumab for macular edema secondary to retinal vein occlusion
Author Affiliations & Notes
  • Turner D Wibbelsman
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Daniel B Calem
    The Sidney Kimmel Medical College at Thomas Jefferson University, Pennsylvania, United States
  • Anthony Obeid
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Phoebe L Mellen
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Michelle A. Konkoly
    The Sidney Kimmel Medical College at Thomas Jefferson University, Pennsylvania, United States
  • Michael R. Velez
    The Sidney Kimmel Medical College at Thomas Jefferson University, Pennsylvania, United States
  • Kareem Sioufi
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Durga S Borkar
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Ravi Pandit
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Michael A. Klufas
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Jason Hsu
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Carl Regillo
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Allen C Ho
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Omesh P Gupta
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Marc J. Spirn
    The Retina Service, Wills Eye Hospital, Philadelphia, Pennsylvania, United States
  • Footnotes
    Commercial Relationships   Turner Wibbelsman, None; Daniel Calem, None; Anthony Obeid, None; Phoebe Mellen, None; Michelle Konkoly, None; Michael Velez, None; Kareem Sioufi, None; Durga Borkar, None; Ravi Pandit, None; Michael Klufas, Allergan (C), Genentech (C), Novartis (C), Novartis (F); Jason Hsu, Genentech (F), Ophthotech (F), Santen (F); Carl Regillo, Allergan (F), Genentech (F), Genentech (C), Iconic (F), Iconic (C), Kodiak (C), Novartis (F), Novartis (C), Regeneron (F); Allen Ho, Genentech (C), Genentech (F), Regeneron (C), Regeneron (F); Omesh Gupta, Regeneron (F); Marc Spirn, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2019, Vol.60, 4057. doi:https://doi.org/
  • Views
  • Share
  • Tools
    • Alerts
      ×
      This feature is available to authenticated users only.
      Sign In or Create an Account ×
    • Get Citation

      Turner D Wibbelsman, Daniel B Calem, Anthony Obeid, Phoebe L Mellen, Michelle A. Konkoly, Michael R. Velez, Kareem Sioufi, Durga S Borkar, Ravi Pandit, Michael A. Klufas, Jason Hsu, Carl Regillo, Allen C Ho, Omesh P Gupta, Marc J. Spirn; Clinical outcomes after switch from aflibercept to ranibizumab for macular edema secondary to retinal vein occlusion. Invest. Ophthalmol. Vis. Sci. 2019;60(9):4057. doi: https://doi.org/.

      Download citation file:


      © ARVO (1962-2015); The Authors (2016-present)

      ×
  • Supplements
Abstract

Purpose : Numerous studies have assessed therapeutic switches in the treatment of retinal vein occlusions (RVO); however, none have evaluated the treatment conversion from aflibercept to ranibizumab. This study analyzes the anatomic and functional outcomes after a switch from aflibercept to ranibizumab therapy for RVO-related macular edema.

Methods : Eyes that received at least 3 consecutive intravitreal aflibercept injections for RVO and then switched to ranibizumab therapy were included. Exclusion criteria included a history of diabetic macular edema, neovascular age-related macular degeneration, uveitis, and a history of vitrectomy, laser photocoagulation, or intravitreal ranibizumab therapy 6 months prior to the switch date. At the three visits before (B3, B2, B1) and after the switch (P1, P2, P3) and the switch date itself, best corrected visual acuity (VA), central foveal thickness (CFT) on spectral domain OCT, and presence of intraretinal and subretinal fluid were assessed. Statistical outcomes were compared using generalized estimating equations.

Results : A total of 82 eyes from 81 patients were included. Eyes received a mean of 14.9 (±7.80) intravitreal injections of aflibercept prior to the switching to ranibizumab. There were no significant differences when comparing logMAR VA and CFT from three visits prior to the switch and the switch visit itself. After the therapeutic conversion, VA worsened significantly from the switch visit [logMAR 0.56 (±0.57)] to the P1 [logMAR 0.62 (±0.55)], P2 [logMAR 0.65 (±0.63)], and P3 [logMAR 0.58 (±0.54)] visits (p=0.04, p=0.02, p=0.03, respectively). CFT increased significantly from the switch visit [244 (±138) µm] to the P1 [308 (±186)] and P2 [287 (±175)] visits, but not to the P3 [255 (±118)] visit (p<0.001, p=0.005, p=0.12, respectively).

Conclusions : Short-term functional and anatomical worsening were observed after switching from aflibercept to ranibizumab for the treatment of RVO mitigated by shortening the ranibizumab treatment interval. With additional ranibizumab treatment administered at a shorter interval between injections, central foveal thickness and VA approached levels similar to those at the switch visit. Longer-term, prospective, controlled studies will be needed to better characterize efficacy and durability differences between aflibercept to ranibizumab in this condition.

This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.

×
×

This PDF is available to Subscribers Only

Sign in or purchase a subscription to access this content. ×

You must be signed into an individual account to use this feature.

×